Provider Demographics
NPI:1366332520
Name:SIMONE, RAFFAELE CHARLES (PA-C)
Entity type:Individual
Prefix:MR
First Name:RAFFAELE
Middle Name:CHARLES
Last Name:SIMONE
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:90 MATAWAN RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2653
Mailing Address - Country:US
Mailing Address - Phone:732-441-7177
Mailing Address - Fax:732-441-7165
Practice Address - Street 1:146 N STATE RT 17 STE 2
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1071
Practice Address - Country:US
Practice Address - Phone:732-906-9600
Practice Address - Fax:833-974-2196
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-08-08
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00955700363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical